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Pseudohypacusis
Deliberate and potentially deceptive exaggeration of hearing loss
Non-organic hearing loss
Functional hearing loss
Signs of Pseudohypacusis
Exaggerated behavior during interview
Unilateral hearing loss with no shadow curve
Poor test-retest reliability
Poor agreement between SRT and PTA
Acoustic reflex thresholds that do not cross check with pure-tone results
Positive Stenger
Present otoacoustic emissions in the face of a PTA greater than 40 dB HL
What is the Stenger Effect?
When a sound is presented to both ears, the listener is aware of its presence only in the ear where it is louder.
Loudness Recruitment
refers to the abnormal perception of loudness that sometimes can occur with a sensorineural hearing loss
Loudness decruitment
as amp increases the loundness stays steady/ becomes harder to hear (not loud enough)
Tone decay
ESPECIALLY in retrocochlear pt. / cannot sustain percept of tone and no acoustic reflex
objective and pulsatile tinnitus
w hearbeat/ vascular/ associated w neoplasm
treatment for tinnitus
maskers/ no caffeine and nicotine/ meds/ rinnitus retraining therapy/ sugery of 8th nerve/ support group
Vertigo
sense of dizziness w a spinning or rotating sensation/ vestibular system may be affected
Treatment for vertigo
meds/ vestibular rehab/ surgery of vestibular portion of 8th nerve
Otologic evaluation
Conducted by ENT
Gathers history
Uses otoscopy
May order images (xray, MRI, CT scans)
Otalgia
Ear pain
Case History includes information about...
Ear pain
Hearing loss
Tinnitus
Discharge (otorrhea)
Dizziness
Outer ear disorders (terms)
microtia - abnormally small pinna
agenesis - absent pinna
atresia - closure of external aud. meatus
external otitis - swimmer's ear (viral or bacterial)
Microtia
Abnormally small pinna
agenesis
absent pinna
atresia
closure of external aud. meatus
external otitis
swimmer's ear (viral or bacterial)
Outer ear disorders
Cerumen - ear wax
Foreign bodies
Cysts and tumors
Exostoses - abnormal outgrowth of bony portion
Exostoses
abnormal outgrowth of bony portion
Middle Ear disorders
Otitis media
Otitis media with effusion
Otitis media with effusion
serous otitis media
serous fluid is a watery, clear fluid from the tissues of the middle ear
caused by eustachian tube malfunction
prevents the ear from ventilating
Effects of otitis media with effusion
Air is trapped in middle ear space
Retraction of TM
Secretion of clear fluid
Effusion may become thickened or mucoid
Acute otitis media
Fluid in middle ear is infected
infection may have come from nasopharynx
often comes with upper resp. symptoms
may or may not have fever
Suppurative otitis media
Filled with excessive blood
Purulent otitis media
Culture medium build up for purulent organisms
Tympanosclerosis
Scar tissue on the eardrum
Cholesteatoma
Accumulation of cellular debris from perforation of TM
Pseudo tumor (outgrowth of tissue)
May cause erosion of ossicles
HL may vary from 15-55 dB
Hearing loss from otitis media
conductive
unilateral or bilateral
Type B (flat) tympanograms
absent reflexes
Otosclerosis
Build-up of spongy bone in area of oval window
footplate of stapes is immobilized
Tympanogram A
s
because ossicular chain is less mobile
Otosclerosis causes only ______ hearing loss because it is part of the _____ ear.
conductive
middle
Cochlear otosclerosis occurs when bone invades the cochlea. This can produce what kind of hearing loss?
Mixed
Hearing loss from otosclerosis
progressive conductive hearing loss
see notch in bone conduction thresholds at 2000 Hz, called Carhart notch
Type A
s
tympanogram
TORCH complex (associated with sensorineural hearing loss)
T - Toxoplasmosis
O - other (Hep B and other viruses)
R - Rubella
C - Cytomegalovirus (CMV)
H - Herpes symplex virus
S - Syphilis
Postnatal infections that can cause hearing loss
Bacterial meningitis
Mumps
Measles
Meniere's disease
caused by overproduction of endolymph fluid
Symptom complex affecting membranous inner ear
Progessive or
fluctuating
sensorineural hearing loss - low frequency
often unilateral
Symptoms of Meniere's Disease
Tinnitus (low pitched)
Feeling of fullness or pressure in the ear
Episodic vertigo
Most often seen between 30-50 years of age
Called endolymphatic hydrops
Ototoxic drugs tend to cause more loss at what frequencies?
High frequencies, but can gradually move to low frequencies
Noise induced hearing loss tends to be more prevalent in what demographic?
Caucasian males
Noise induced hearing loss will show a notch in both air and bone conduction at what frequencies?
4000 Hz and 6000 Hz
Reasons for notch in noise-induced hearing loss
Resonances of outer ear @ 2000Hz - 4000 Hz increases the level
Cochlear structure - basilar end of cochlea is hit first. Basilar end is responsible for high frequencies
Damage to outer hair cells
Presbycusis
sensorineural loss caused by aging
Characteristics of Presbycusis
bilateral
sensorineural
sloping or ski slope audiogram
Retrocochlear pathology
part of sensorineural hearing loss
retrocochlear refers to neural loss
OAE would be normal
Author
amykath
ID
119748
Card Set
AUD 1
Description
Audiological disorders review
Updated
2011-11-30T05:50:57Z
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